NEW ON SKEPTICBLOG.ORGAn Open Letter to Bill Maher on Vaccinations

Michael Shermer shares his open letter to Bill Maher urging him to reconsider his postion on vaccination. This post originally appeared on the Huffington Post on October 16, 2009. • READ the blog post •

In this week’s eSkeptic, J. D. Haines, MD reminds us that chiropractic is a dangerous threat to public health. In an age where phenomenal medical discoveries have improved the health and extended average longevity to almost 80 years, chiropractic remains a holdover from the days of the snake oil salesmen.

J. D. Haines, MD has over 20 years experience in family and emergency medicine. He is a Fellow of American College of Sports Medicine, and Clinical Associate Professor of Family Practice at the University of Oklahoma.

engraving of a spinal column from Henry Gray’s Anatomy of the Human Body, 1918.

Fatal AdjustmentsHow Chiropractic Kills

by J. D. Haines, MD

When Kristi Bedenbaugh wanted relief from a bad sinus headache, the 24 year-old former beauty queen and medical office administrator made the mistake of consulting a chiropractor. An autopsy performed on Kristi revealed that the manipulation of her neck had split the inner walls of both vertebral arteries, resulting in a fatal stroke.

The chiropractor’s violent twisting of her neck caused the torn arterial walls to balloon and block the blood supply to the posterior portion of her brain. Studies confirmed that the blood clots formed on the two days she received her neck adjustments.

Kristi died in1993. Four years later, South Carolina’s State Board of Chiropractic Examiners fined the chiropractor $1000 and sentenced him to 12 hours of continuing medical education in the area of neurological disorders and emergency response.

item of interest…

The Borderlands of Science

Where does valid science leave off and borderland science begin? This book and lecture examines the theories, the people and the history involved in areas of controversy where sense is in danger of turning into nonsense.

Supporters of chiropractic are quick to claim that cases like this are rare. Try telling that to Kristi’s family — no matter how great the odds, the outcome was 100% fatal for her. The real problem is that there are no valid statistics concerning the risk of stroke after neck manipulation. Aside from anecdotal reports like Kristi’s and a few surveys, little clinical research has addressed this problem.

Two recent studies reveal the tip of the iceberg. In 1992, researchers at the Stanford Stroke Center surveyed 486 California neurologists regarding how many patients they had seen within the previous two years who had suffered a stroke within 24 hours of neck manipulation. One hundred seventy-seven neurologists responded, reporting 55 patients between the ages of 21 and 60. One patient died and 48 were left with permanent neurological impairment.

A review of 116 journal articles published between 1925 and 1997 reported 177 cases of neck injury caused by manipulation. Sixty percent of these cases resulted from injury inflicted by chiropractors.

The real tragedy is that cervical spine manipulation is totally worthless in treating problems like Kristi Bedenbaugh’s. So, however rare the incidence of adverse outcome, the risk always outweighs any perceived benefit. There is no medically proven benefit whatsoever to chiropractic manipulation of the cervical spine.

While it may be argued that chiropractic is helpful for some cases of low back pain, the claims that over 90 different medical illnesses may be successfully treated by spinal manipulation is without any scientific evidence. The Medical Letter on Drugs and Therapeutics stated on May 27, 2002, “For neck and low back pain, trials have not demonstrated an unequivocal benefit of chiropractic spinal manipulation over physical therapy and education.” The report continues: “Repeated reports of arterial dissection and stroke associated with cervical spine manipulation and cauda equina syndrome associated with manipulation of the lower back suggest a cause and effect relationship.”

The report concludes, “Spinal manipulation can cause life-threatening complications. Manipulation of the cervical spine, which has been associated with dissection of the vertebral artery, appears to be especially dangerous.”

The major problem with chiropractic is that it was founded upon the false premise that correction of vertebral subluxations will restore and maintain health. Chiropractic philosophy maintains that disease or abnormal function is caused by interference with nerve transmission due to pressure, strain, or tension upon the spinal nerves due to deviation or subluxation within the vertebral column.

Daniel David Palmer, a tradesman who posed as a magnetic healer, discovered chiropractic in 1895. Palmer’s first patient was a deaf janitor who had his hearing restored after Palmer adjusted a bump on his spine. According to Dr. Edmund Crelin, “Magnetic healing was a popular form of quackery in the 19th century in which the healers believed that their personal magnetism was so great that it gave them the power to cure diseases.” Palmer summarized his new science:

I am the originator, the Fountain Head of the essential principle that disease is the result of too much or not enough funtionating [sic]. I created the art of adjusting vertebrae, using the spinous and transverse processes as levers, and named the mental act of accumulating knowledge, the cumulative function, corresponding to the vegetative function — growth of intellectual and physical-together, with the science, art and philosophy — Chiropractic. It was I who combined the science and art and developed the principles thereof. I have answered the question — what is life?

Palmer’s egotistical and ridiculous claims are familiar to those who have studied leaders of religious cults. Incredibly, Palmer’s philosophy remains the basis of modern-day chiropractic thinking. Palmer’s claim that chiropractic answers the question, “What is life?” would be laughable if not for a gullible public who readily accept quackery.

The public is led to believe that physicians disparage chiropractors out of some sort of professional jealousy. Yet there is only one reason that physicians judge chiropractors so harshly. Medicine is scientifically based, whereas chiropractic is not supported by a single legitimate scientific study.

In the first experimental study of the basis of chiropractic’s subluxation theory, Dr. Edmund S. Crelin, then an anatomy professor at Yale University, demonstrated that chiropractic theory was erroneous. As retired chiropractor Samuel Homola writes, “Using dissected spines with ligaments attached and the spinal nerves exposed, he used a drill press to bend and twist the spine. Using an ohm meter to record any contact between wired spinal nerves and the foraminal openings, he found that vertebrae could not be displaced enough to stretch or impinge a spinal nerve unless the force was great enough to break the spine. Crelin concluded, ‘This experimental study demonstrates conclusively that the subluxation of a vertebrae as defined by chiropractic — the exertion of pressure on a spinal nerve which by interfering with the planned expression of Innate Intelligence produces pathology — does not occur.’”

Physicians have long recognized that spinal nerves are commonly pinched by bony spurs and herniated discs, resulting in musculoskeletal symptoms, without any effect on visceral function, as claimed by chiropractic. Chiropractic theory ignores that the autonomic nervous system maintains the function of the body’s organs, even in spinal cord lesions.

item of interest…

The SKEPTIC Encyclopediaof Pseudoscience

Two volumes full of case studies, historical documents, and a pro/con debate section. Read more…

Chiropractors are notorious for performing unnecessary X-rays and so-called maintenance care that often corresponds to the duration of the patient’s insurance coverage. The greatest threat of chiropractic, however, may be to infants and children. As Homola explains, “Parents are lured by claims that spinal adjustments at an early age can prevent the development of disease and that vaccination may not be necessary.” There remains no medical or scientific basis for the treatment of infants and children. A more subtle danger represented by chiropractic is the campaign for public acceptance as primary care providers. The clinical training received by chiropractic students is greatly inferior to that of medical students and residents.

In today’s climate of government-sanctioned alternative therapies, the ignorant consumer may be fooled by slick marketing to believe that chiropractors are qualified to treat a broad range of diseases. As alternative medicine gains wider acceptance, public health will surely suffer. Stephen Barrett, MD, has written that the real enemy of chiropractors is themselves:

Your basic enemy is yourself. Your colleagues engaged in unscientific practices, economic rip-offs, cheating insurance companies, selling unnecessary supplements and generally overselling themselves. Most chiropractors would like to believe that the number of such colleagues is small. I think it is large and may even be a majority.

As far back as 1924 essayist H. L. Mencken recognized chiropractors as quacks:

Today the backwoods swarm with chiropractors, and in most States they have been able to exert enough pressure on the rural politicians to get themselves licensed. Any lout with strong hands and arms is perfectly equipped to become a chiropractor. No education beyond the elements is necessary. The takings are often high, and so the profession has attracted thousands of recruits — retired baseball players, work-weary plumbers, truck-drivers, longshoremen, bogus dentists, dubious preachers, cashiered school superintendents. Now and then a quack of some other school — say homeopathy — plunges into it. Hundreds of promising students come from the intellectual ranks of hospital orderlies.

As practiced today, chiropractic is a threat to public health. In an age where phenomenal medical discoveries have improved the health and extended average longevity to almost 80 years, chiropractic remains a holdover from the days of the snake oil salesmen. Every year trusting and naïve Americans suffer needless injury and death due to dangerous cervical spine manipulation. The investigation of the true frequency of complications from chiropractic is a duty that public health officials have long neglected and should undertake at once.

Mr. Deity and the Science Advisor

The science advisor (played by PZ Myers of Pharyngula fame) informs Mr. Deity that his design for the humans leaves something to be desired.

Some of the book’s key messages (don’t be so cerebral; don’t be so literal-minded; don’t be such a poor story teller; don’t be so unlikable) are also on display in Dr. Olson’s newest feature film, Sizzle: A Global Warming Comedy. The new movie, a mockumentary that humorously relates just how hard it is to get a film about science made in style-conscious Hollywood, is the closing film at the Imagine: Science Film Festival in New York this week.

upcoming lectures…

Whole Earth Discipline

An Ecopragmatist Manifesto

According to Stewart Brand, a lifelong environmentalist (and creator of the Whole Earth Catalog) who sees everything in terms of solvable design problems, three profound transformations are under way on Earth right now. Climate change is real and is pushing us toward managing the planet as a whole. Urbanization — half the world’s population now lives in cities, and 80% will by midcentury — is altering humanity’s land impact and wealth. And biotechnology is becoming the world’s dominant engineering tool. In light of these changes, Brand suggests that environmentalists are going to have to reverse some long held opinions and embrace tools that they have traditionally distrusted…

followed by…

Carl Zimmer will lecture onSunday, November 1, 2009 at 2:00 pm

The Tangled Bank

An Introduction to Evolution

with Carl Zimmer

Sunday, Nov. 1, 2009, 2 pmBaxter Lecture Hall, Caltech

Zimmer, an award-winning science writer (New York Times, Discover), takes readers on a fascinating journey into the latest discoveries about evolution. In the Canadian Arctic, paleontologists unearth fossils documenting the move of our ancestors from sea to land. In the outback of Australia, a zoologist tracks some of the world’s deadliest snakes to decipher the 100-million-year evolution of venom molecules. In Africa, geneticists are gathering DNA to probe the origin of our species. In clear, non-technical language, Zimmer explains the central concepts essential for understanding new advances in evolution, including natural selection, genetic drift, and sexual selection. He demonstrates how vital evolution is to all branches of modern biology — from the fight against deadly antibiotic-resistant bacteria to the analysis of the human genome.

The Baloney Detection Kit Sandwich (Infographic)

For a class project, a pair of 11th grade physics students created the infographic shown below, inspired by Michael Shermer’s Baloney Detection Kit: a 16-page booklet designed to hone your critical thinking skills.